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See a sample rate comparisonCPT 61616 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Resect Excise Lesion Skull, Resection Or Excision Of Neoplastic Vascular Or Infectious Lesion Of Base Of Posterior Cranial Fossa Jugular Foramen Foramen Magnum Or C1 C3 Vertebral Bodies Intradural Including Dural Repair With Or Without Graft
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Nervous System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 62 - Co-Surgeons 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 61616 |
| Medicaid Fee Schedule | View Medicaid rates for 61616 |
National average reimbursement for CPT 61616 by major payers:
$4,239.39
$4,518.87
$4,837.37
$5,346.47
Compare published rates across providers.
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CPT 61616
5 of 25 sample ratesHigher to lower in this preview
Hunt Memorial Hospital District, Hunt Regional Healthcare
Hunt Memorial Hospital District
$5,600.00Published ratePalm Beach International Surgery Center LLC, Palm Beach International Surgery Center At The Paley Institute
Palm Beach International Surgery Center LLC
$1,274.00Published rateIpm Surgery Centers LLC, Spinalcare Surgicenter
Ipm Surgery Centers, Inc
$665.00Published rateRockledge Surgery Center, Inc.
Rockledge Surgery Center Inc
$400.00Published rateAmerican Access Care Of Sp Asc LLC
$150.00Published rate
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See a sample payer proposalCPT 61616 vs. Other Surgical Procedures on the Nervous System Codes
The CPT 61616 code is part of the Surgery services used for Surgical Procedures on the Nervous System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 61616 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 61600-CPT | High | Resection Or Excision Of Neopl, Resection Or Excision Of Neoplastic Vascular Or Infectious Lesion Of Base Of Anterior Cranial Fossa Extradural Resection Or Excision Of Neoplasticvascular Or Infectious |
| 61605-CPT | High | Resect/Excise Cranial Lesion, Removal Of Tumor Or Tissue Abnormality Of Lower Skull Base (Infratemporal Fossa Parapharyngeal Space Petrous Apex) External To Membranes Covering Brain Extradural |
| 61615-CPT | High | Surgery To Remove Brain Tissue, Surgery To Remove A Growth Tumor Or Infected Tissue From The Back Portion Of The Brain. The Procedure May Include A Graft And Repairs The Membrane Covering The Brain (Dura). |
| 61616-CPT | High | Resect Excise Lesion Skull, Resection Or Excision Of Neoplastic Vascular Or Infectious Lesion Of Base Of Posterior Cranial Fossa Jugular Foramen Foramen Magnum Or C1 C3 Vertebral Bodies Intradural Including Dural Repair With Or Without Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 61616. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 61616 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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